Insurance Companies Most Likely to Deny a Claim, According to Medical Billers

Date:December 01, 2019 By:Admin

Insurance Companies Most Likely to Deny a Claim, According to Medical Billers

Are you a medical provider, seeking to learn more about the insurance companies you work with on a day to day basis? Look no further—because we’ve got you covered. Those of us at Credentialing.com know that staying informed on varying insurance companies can get tricky. So, we gathered some important information for you to consider, by simply asking 10 medical billers a series of questions pertaining their experiences with said health insurance companies. One of those being: Which insurance company is most likely to deny a claim? Read the subsequent results below:

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As you can see, responses varied greatly, but the bulk of survey participants said that UnitedHealthcare, TRICARE, and Blue Cross Blue Shield were all likely to deny a claim—each company received 20% of the votes. The remaining 40% of votes were equally distributed between Cigna, Magellan Health, Humana, and Medicare, with each company receiving 10% of the votes.

A Glance at These Companies and Their Culture
Get a quick inside look at what these companies are all about:

UnitedHealthcare (20% of votes)
UnitedHealthcare, which received 20% of the medical biller’s votes for “most likely to deny a claim,” caters to their customer needs by offering multiple insurance plans that cover dental, vision, and more. They are brought together by their “mission to help people live healthier lives and make the health system work better for everyone.” Additionally, this company prides itself on benefiting both individuals and employers.

TRICARE (20% of votes)
TRICARE, which also received 20% of the survey votes, has a central focus on providing uniformed service members and their families with quality and reliable healthcare. And one of their primary goals, as described in their mission and vision statements, is to enhance our nation’s security by doing just that.

Blue Cross Blue Shield (20% of votes)
Rounding out the three companies tied with 20% each of survey votes is Blue Cross Blue shield. This insurance company is dedicated to employing experienced members and, in turn, providing customers with high-quality and affordable coverage. Additionally, they remain a beloved company by, “rising to the challenges that change brings, enabling new discoveries, and continuing to evolve,” according to Blue Cross Blue Shield’s webpage.

Cigna (10% of votes)
Cigna, which received 10% of the survey votes, got its start over 200 years ago; however, since its initial development, Cigna has transformed into a totally new company that focuses on improving their customers’ health, well-being, and sense of security. Furthermore, they claim to prioritize great relationships between the team members and the customers.

Magellan Health (10% of votes)
Magellan Health was also voted by 10% of voters as most likely to deny a claim. This company thrives off of fulfilling their three core values: integrity, accountability, and caring. According to their webpage, living by these morals helps them, “lead humanity to healthy vibrant lives.” In addition, Magellan Health prioritizes interconnectedness, as they view behavioral, physical, social, and pharmaceutical needs as equally important realms of health.

Humana (10% of votes)
Humana, a company to receive another 10% of votes, prides itself on working with a multitude of customers—families, military members, seniors—and its ability to fulfill their varying needs; the standards they hold their employees allow them to do so. Additionally, Humana sets the highly-esteemed goal of not only improving the health and wellbeing of their customers, but of the planet as a whole.

Medicare (10% of votes)
Closing out the survey results, Medicare, too, received 10% of votes. This company caters specifically to individuals who are 65 years or older, individuals who have certain disabilities, and people with End-Stage Renal Disease. Depending on the given situation and customer, Medicare ultimately covers specific healthcare services, like doctor’s visits, medications, inpatient and outpatient care.

In Conclusion
Your decision to work with a particular insurance company should not rely solely on whether they’re likely to deny a claim. It’s important you remember that every company has valid reasons for denying a claim: a service or procedure isn’t covered by the given policy; a pre-authorization is required; or something as simple as timeliness just can’t allow it. That being said, this is still important information to review and a significant factor to weigh—but there are plenty of others awaiting your due consideration.

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